Unfortunately, we come across many traumatised teeth during our practising career. Some of these traumatic injuries are rather simple to treat whereas others provide us with a real challenge. It is absolutely essential that the diagnosis of the injury be known before any treatment is attempted. When it comes to trauma, however, defining the exact form of treatment can often be very difficult. In this paper I will discuss some of the cases that I have managed and leave it up to YOU to decide whether my treatment has been correct, incorrect or whether there is some other form of treatment that we have at our disposal that could have been attempted.

Adolescent↗

PubMed1996

Dental pulp response to traumatic injuries--a retrospective analysis with case reports.

The reactions of the dental pulp to traumatic injuries can be extremely varied. They range from almost immediate pulp death to long-term slow pulp canal calcification. In this study the pulpal reactions were divided into three types: pulps with a very poor prognosis that required endodontic therapy soon after the tooth was traumatized. Seventy-nine teeth were studied in this category, and all 79 teeth required endodontic therapy; pulps with a moderate prognosis that required endodontic intervention some 18 to 24 months after the traumatic episode. Forty-eight teeth were studied in this category, and 27 of them required endodontic therapy: pulps with a very good prognosis that rarely required endodontic therapy. Fifty-two teeth were studied in this category, and only 2 required endodontic therapy. The prognosis of a particular pulp depends on the degree and type of trauma.

Adolescent↗

PubMed1995

Clinical management of transverse root fractures.

Successful management of a tooth that has sustained a transverse root fracture depends on three major factors: the position of the fracture line, the extent of mobility of the coronal segment, and the state of the pulpal tissue. The position of the fracture line and its relationship to the base of the gingival crevice are the most important factors in determining the long-term prognosis for the tooth.

Dental Pulp Necrosis↗

PubMed1994

Aspects of dentinal and pulpal pain. Diagnosing dental pain.

Patients present with a large variety of different pain patterns. Some types of pain will be quite excruciating and intolerable whereas other types of pain will be low grade, annoying but quite tolerable. It is only by carefully going through the complete history with the patient and using the appropriate test or tests that one can accurately diagnose the pain and positively treat the offending tooth.

Dental Pulp Diseases↗

PubMed1989

Effects of post placement on endodontically treated teeth.

The effect of endodontic therapy, post-hole preparation, and post placement on tooth models of maxillary central incisors was investigated. Two-dimensional photoelastic analysis of birefringent models, under load in a polariscope, indicated the relative stress magnitudes and concentrations at the cervical and apical regions. Within the limits of the method, the results suggest that enlargement of the canal increases cervical stresses and that post placement will decrease stresses in this region. Nevertheless, conservative enlargement of the root canal may render post placement unnecessary for largely intact teeth. Post length appeared more important than post diameter in determining relative stresses at the cervical region. However, short wide posts led to elevated stress concentrations in this region. Post placement beyond two thirds of the root depth did not further decrease cervical stresses but usually increased stresses in the apical region.

Crowns↗

PubMed1987

Effect of some endodontic sealers on cell migration in experimental granulomas.

CRCS or calciobiotic root canal sealer (a calcium hydroxide-based sealer), Proco-sol and Tubliseal (both zinc oxide eugenol-based sealers), and Diaket-A (a polyvinyl-based sealer) were assessed for their relative cytotoxicities by their different cell migration effects by means of glass coverslip granulomas. Cytotoxicity was assessed by means of the influx of mononuclear cells or macrophages and their transformation into multinucleate giant cells. CRCS was shown to be the best sealer, followed by Proco-sol and Tubliseal. Diaket-A was the most cytotoxic of the sealers tested.

Animals↗

PubMed1987

A 6-year recall study of clinically chemically bleached teeth.

Chemical bleaching of discolored teeth gives a 45% rate of success after 6 years. While chemical bleaching will usually give adequate color for sufficient time for the gingival margin to stabilize in a young tooth, chemical bleaching cannot be recommended as a permanent treatment in an adult tooth.

Age Factors↗

PubMed1987